Digital inclusion | Social care

The digital revolution of health and care services in Wales risks excluding the most vulnerable, says new report

As the NHS and social care sector in Wales progresses its digital transformation agenda, there is a real danger that those citizens most in need of accessing health services will be left behind, due to their lack of digital skills and access, says new report.

By Jo Brown · November 7, 2018

See this page in: Cymraeg

According to the report – Digital Inclusion in Health and Care in Wales – one in four people with limiting long-standing illness, disability or infirmity are not currently using the internet, compared with only 10% of those without such a condition. Most crucially, 25% of men and 32% of women aged 65 to 74 in Wales are not online, compared with only three percent of 16 to 49-year olds.

The report, commissioned by the Wales Co-operative Centre and the Carnegie UK Trust, was launched at today’s (Wednesday, 7 November) Digital Health and Care Conference Wales on the same day the Cabinet Secretary for Health and Social Care Services, Vaughan Gething AM, announced a £3m investment to tackle digital exclusion within health and care.

The report identifies many examples of digital inclusion good practice in health and care settings in Wales, particularly through Digital Communities Wales, a dedicated digital inclusion programme delivered by the Wales Co-operative Centre and funded by Welsh Government. One of the initiatives run by the project is Digital Heroes, where young people befriend older people and introduce them to digital technology, often with inspiring and transformative results.

Despite a number of Health Boards in Wales delivering vital work in combating digital exclusion through staff training and support with online patient portals and telehealth services, the report highlights the majority of Health Boards in Wales are still making no reference to digital inclusion in their digital strategies or Integrated Medium Term Plans.

Bob Gann, author of the report and former programme director of Widening Digital Participation, the national digital inclusion programme for the NHS in England, said:

“The messages from the report are clear. We need to bring digital inclusion higher up the agenda, and embed it in the mainstream of health and care in Wales. We need to be able to measure the impact of digital inclusion through outcomes which are relevant to the NHS and social care – including increased self-care and appropriate use of services.

“And as we rethink some our approaches to digital inclusion for health and care, we will be most successful if we work with patients and service users to co-produce solutions which matter to them, and are accessible and well-designed.”

To view and download the full report please visit www.wales.coop/digital-inclusion-report-2018

Inspiring case studies highlighted in the report:

Woffington House is an innovative care home for seniors in Tredegar. The care home has developed a partnership with local primary schools, whereby schoolchildren visit residents on a regular basis. Children from Georgetown Primary School have been Digital Heroes, befriending residents and showing them how to use technology, using tablets loaned by Digital Communities Wales. Residents particularly enjoy visiting places they used to go to, online.

Ken (not his real name) has lived at Woffington House for over two years. He has no family and has no visitors. He suffers with anxiety, mild depression and lives with dementia. At times he would bite his knuckles and hit door frames because of his frustrations. He was prescribed Lorazepam when necessary. Using an iPad and Virtual Reality glasses, Ken has been able to revisit Aberystwyth in 1965 as well as go on rollercoaster rides. He also loves looking up songs using YouTube. Ken’s health and well-being has improved dramatically and gone are the days of anti-psychotic medications.

Ken has also been researching pigeon racing with the children. The children are now going to come to the home and extend the activity further by letting off racing pigeons from the care home car park. Ken’s hobby has been brought to real life as a result of the Digital Heroes scheme.

Ken’s experience is typical in the care home, where anti-psychotic medication on an “as required” basis has been reduced by 100%. Falls have also been reduced significantly and ambulance call outs (which cost the NHS £300 a time) have been reduced by 28%. Furthermore, staff morale has been boosted – and primary school children say they want to work in care professions when they grow up.

ABMU is one of the few Health Board’s that has been at the forefront of citizen-facing digital initiatives in Wales, becoming the first Health Board to offer free public Wi-Fi in a hospital and in every acute and community health hospital across the Health Board.  It was also the first Health Board to offer patients an online patient-controlled record, Patient Knows Best (PKB), and is currently working with Digital Communities Wales to provide support to patients to use PKB and other online applications by signposting them to libraries or other community resources where they can have access to a computer and support with setting up email etc.

In the Betsi Cadwaladr Health Board area, patients over 85 (one patient was over 100) are seeing their doctor via telemedicine clinics at their local community hospital. This has reduced travelling for many patients from 30 miles to 2-5 miles. Dr Olwen Williams says:

“Co-production was essential for success in setting up the telemedicine service because uptake and delivery are entirely dependent on both clinical and patient groups buying into a service model that meets the needs of the majority. User engagement from the outset can be facilitated by working with agencies, such as Citizens Online, that focus on digital inclusion, dispelling myths and anxieties, and providing training and support.”

Significant positive feedback has been received from patients, with over 83% stating that they would recommend the clinics to family and friends. Patients have saved on average 64 minutes of travel time (40 miles) to and from the clinics.

Cabinet Secretary for Health and Social Care, Vaughan Gething AM, said:

“As this report shows, increasing digital inclusion can improve health and well-being. Giving people the skills to access the right information and services has been shown to enable them to better manage conditions and reduce the burden on NHS services. That is why I am announcing an extra £3m over three years to improve digital inclusion among health and care professionals and the public.”

Karen Lewis, Director of Communities and Inclusion at the Wales Co-operative Centre, said:

“The rapid growth in digital technologies brings transformative opportunities for people to become more active partners in their own care, interacting with services with the convenience they have come to expect in other areas of their lives. However, what we still find is that many citizens with the greatest need for health and care provision are also those with the lowest level of digital skills, with lack of access, skills, interest, motivation and trust increasingly the reasons for them not going online.”

Douglas White, Head of Advocacy at Carnegie UK Trust said:

“Digital technology has great potential to tackle inequality and transform access to public services but we know that those who could benefit the most from technology are often the least likely to use it. We need urgent action to address this. We have been very pleased to work with the Welsh Co-operative Centre over the past year to examine how to respond to the digital challenge in health and social care in Wales. The report published today sets out the priorities and gives a clear road map for action.”